Cognitive behavioral therapy in addition to pharmacotherapy for manic depressive disorders. Empirical results

Medications will be always necessary in the treatment of bipolar affective disorders. More and more, however, the importance of an adjunctive psychotherapy is emphasized. Numerous controlled therapy trials showed that unipolar depressed patients can be effectively treated with cognitive behavior therapy (CBT). Therefore a literature search was done to check for the empirical evidence concerning the efficacy of CBT for bipolar disorders. We conducted a literature search using Medline, PsycINFO, and Psyndex, considering all publications dealing with the topic "psychotherapy and bipolar disorder" till July 2001. This search resulted in 241 articles. Ten percent of these publications were considered to be controlled trials. Four studies explicitly tested the efficacy of CBT. Compared to standard medical treatment, CBT proved to be efficient concerning symptomatic and functional outcome. However, there remain many questions to be answered, e.g., if there are differential effects on the course of manic and depressive symptoms and how stable the results will be in the long run.